Marshall - Benefits

Question 1

What are the component benefits of Ontario’s mandatory auto insurance system?

Answer 1

• no fault (AB): provides benefits regardless of fault

- tort (BI): allows you to sue the at-fault driver

Question 2

Which is true for Ontario auto insurance, benefits are fair or delivered fairly?

Answer 2

• Benefits ARE fair

- but benefits are NOT DELIVERED fairly

Question 3

What are the causes of unfair delivery of auto insurance benefits in Ontario? (4)

Answer 3

Cost control at the expense of care
- insurers emphasize cost control instead of care
- but the victims don’t recover and final costs are HIGHER
Lawyers
- contingency fee are a percentage of settlement
- so lawyers seek higher settlements, not better care for victims
Entitlements
- victims seek to maximize entitlements versus addressing own care needs
Volume
- providers are paid on VOLUME of treatments, not result

Question 4

Identify the ACTION ITEMS on ON’s 5-part ACTION PLAN for addressing the unfair delivery benefits.

Answer 4

• structural flaws: fix structural laws by appointing an arms-length regulator with powers to enact policies & procedures
• catastrophic injuries: change compensation system for CAT injuries because lawyers are taking too big a chunk
• care for cash: focus on timely, appropriate medical care, not cash payouts
• lawyers: make contingency fees transparent (simplify benefits so there is less need to hire lawyers)
• smart regulation: allow insurers more regulatory freedom to compete on price & service

Question 5

What the ‘opportunity gap’ in ON auto insurance?

Answer 5

There is an OPPORTUNITY for ON auto premium to be much lower without impacting quality.

Question 6

What is the ‘value gap’ in ON auto insurance?

Answer 6

The VALUE of medical care could be better if there were more focus on active medical management.

Question 7

Identify 1 similarity and 1 difference in the BC& ON auto products.

Answer 7

Similarity: both are mandatory
Difference: BC is public and ON is private

Question 8

Identify 1 similarity and 1 difference in the problem with BC & ON auto insurance.

Answer 8

Similarity: severity is increasing for minor injuries
Difference: frequency is increasing for BC and decreasing for ON

Question 9

Identify 1 similarity and 1 difference in the proposed solutions regarding BC & ON auto insurance.

Answer 9

Similarity: shift focus from cash to care
Difference: BC emphasizes product redesign and ON emphasizes structural changes in regulatory system

Question 10

Which is a better auto insurance system, public or private?

Answer 10

Neither!
The goal of sustainability & affordability can be met by either with a properly designed product & regulatory system.